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Effective Nurse/Non Medical Prescribing in End of Life Care: Speaker news and updates

This conference focuses on the important issue of Nurse/Non Medical Prescribing in End of Life Care. It is widely recognized that pain and symptom control at the end of life is not always optimal, the development of non medical/nurse prescribing has a key role in improving pain and symptom control for patients at the end of life. The conference, which includes national updates, extended in depth sessions and case studies will focus on developing your skills as a non medical/nurse prescriber in end of life care.

Speaker Presentations and updates

Claire Henry, Chief Executive of The National Council for Palliative Care, and chair of todays conference opened the event with an update on the national context. Every minute someone in the UK dies, there are still too many reported cases of poor care, older people are living longer with multiple conditions. 72% say they would like to die at home but currently 42% of people die in hospital, 23% die at home, 21% die in care homes and 6% in hospices. However 82% said they felt their relatives died in the right places emphasizing that hospital is the right place for many people.

Claire also discussed the Dying Matters Campaign ‘What can you do?’ – lots of helpful resources available at . Clare concluded stating that we have one chance to get this right

Nurse/Non Medical Prescribing: National Update

Marion Russell Medicines Management Advisor Association of Prescribers

  • national developments in nurse/non medical prescribing
  • developing confidence and competence in your ability to prescribe
  • demonstrating compliance with the NMC Code for revalidation
  • the benefits of nurse/non medical prescribing in end of life care

Marion Russell Full Presentation Click Here

Marion Russell's Abstract: 

The number of professions now able to register as non-medical prescribers is expanding as the demands made on the NHS and other Health Care providers continues to increase.

This brings with it the need to ensure that medicines are not only prescribed safely but those who undertake this task are capable and competent to do so.

The new NMC Code for nurses and midwives sets out quite clearly that patient safety is the registrant's responsibility.

This presentation seeks to link all of these facets together and help to set the scene for the conference.  

Marion discussed the new competency framework for all prescribers released by the RPS last year – a copy is available here

Marion also discussed the NMC code of conduct which was updated last year here

Nurse/ Non Medical Prescribing for symptom control in End of Life Care

Sheila Dawson Member National Nurse Consultant in Palliative Care Group & Nurse Consultant in Palliative Care St Theresa’s Hospice

  • nurse/non medical prescribing for symptom control: current issues
  • improving confidence in prescribing practice
  • empowering nurses/non medical prescribers to prescribe in end of life care
  • improving nurse/non medical prescribing practice
  • supporting nurse/non medical prescribers: infrastructure needed to support the safe and effective development and implementation of nurse prescribing
  • developing advanced roles around nurse/non medical prescribing
  • keeping your prescribing knowledge up-to-date: accessing education, training and resources

Sheila Dawson Full Presentation Click Here

Sheila Dawson’s Abstract:

Independent non-medical prescribing is now practiced widely amongst specialist palliative care nurses throughout the UK, and has been shown to improve patients’ access to medications, and their symptom management at the end of life.  In County Durham and Darlington most Macmillan CNSs are Independent NMPs and, unlike seven years ago when I started my prescribing career, most patients now expect their CNs to prescribe.

This presentation will consider national, local and organisational factors which impact on my prescribing. It will also consider whether the goals of Independent NMP (DH 2006) have been attained.  Prescribing within my role is essential in order for patients under my care to have consistent, seamless and prompt care when their time is limited and quality of life is of paramount importance. However, equally important in prescribing is being able to conduct clinical examinations, facilitating more in depth assessments which are key in informing prescribing decisions. This will be demonstrated in a brief case study.

Alongside the positive aspects of NMP, such as reduction in hospital admissions, fewer GP consultations, and more efficient use of practitioners’ skills, there are several factors which hinder the progression of Independent NMP in the hospice.  These include poor retention of trained NMPs, a relatively low number of stock drugs, and staffing issues. National barriers to effective NMP at the hospice are increasing unavailability of medication, inconsistent practices and policies between organisations – particularly around use of medication via syringe drivers and anticipatory prescribing – which can be detrimental to the wellbeing of patients and  their families/friends.

Sheila Dawson’s Biography:

Sheila has been a nurse prescriber for fifteen years, seven of which as an Independent non-medical prescriber (NMP) in specialist palliative care nursing. Sheila’s first post in 2006 was a Community Macmillan CNS in Central Manchester, including one day a week working with the palliative care team in the Manchester Royal Infirmary. In 2009 Sheila joined Wigan and Leigh Hospice, also as a Palliative Care CNS, where she was heavily involved in introducing Independent Non-medical Prescribing among the CNSs.

In May 2012 Sheila attended the European Palliative Care Conference in Lisbon where she presented a poster on implementing Independent NMP in the hospice. Sheila also had an article published in the Nurse Prescriber 2013 11(5) investigating the time taken for community palliative patients to receive their medication when prescribed by GP compared to when prescribed by myself. The results identified that most patients received their medication thirty four hours sooner when prescribed by an NMP.

Sheila is currently employed as a Nurse Consultant in Palliative Medicine at St Teresa’s Hospice, Darlington, which is a nurse-led facility. Currently she is the sole prescriber there and undertakes most of the symptom management for patients on the seven bedded in-patient unit as well as for Day Hospice and some community patients. GPs have responsibility for their own patients, which entails seeing them fortnightly to avoid having to report their deaths to the Coroner. In addition there is a Hospice Physician who works with me one day a week. They do have access to the Consultant in Palliative Medicine who attends our weekly MDT and is available for advice and will review complex patients if requested.

Future events of interest:

End of Life Care: Legal Issues Masterclass
Monday 13 March 2017 
De Vere West One Conference Centre, London

Nurse/Non Medical Prescribing in Cardiology
Friday 31 March 2017 
De Vere West One Conference Centre, London

End of Life Care: Advanced Legal Issues Masterclass
Monday 15 May 2017 
De Vere West One Conference Centre, London

Demonstrating & Improving Prescribing Competence & Practice: Implementing the New National competency framework for all prescribers
Friday 19 May 2017 
De Vere West One Conference Centre, London

Nurse/ Non Medical Prescribing in Cancer Care
Monday 5 June 2017 
De Vere West One Conference Centre, London

Care of Dying Adults in the last days of life: Implementing the 2017 NICE National Quality Standard
Monday 12 June 2017 
De Vere West One Conference Centre, London

Transforming End of Life Care in Acute Hospitals
Wednesday 12 July 2017 
Manchester Conference Centre, Manchester

24 February 2017


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